INCREASED CREATINE PHOSPHOKINASE AS A DIAGNOSTIC PROBLEM IN A MULTIMORBID PATIENT WITH COVID-19 (CLINICAL OBSERVATION)

Abstract

Relevance. Creatine phosphokinase is an enzyme that is often associated with muscle and myocardial damage. However, there may be other causes of elevated levels of this enzyme, such as stroke, hypothyroidism, paraneoplastic syndrome, as well as various pharmacological effects, including taking statins and the development of statin-associated muscle symptoms, the consequences of a previous coronavirus infection - COVID-19.The aim of the work is to determine the cause of an increase in creatine phosphokinase in a patient who has suffered a coronavirus infection against the background of concomitant diseases, and to conduct a differential diagnosis of an increase in this enzyme.Results. An analysis of the patient's medical history with a significant increase in the level of creatine phosphokinase was performed and a subsequent differential diagnosis was carried out to identify the main causes of this change. The study was carried out based on the general condition of the patient, as well as the results of general and biochemical blood tests (including the level of creatine phosphokinase and lactate dehydrogenase), and instrumental studies were also carried out, such as electroneuromyography, electrocardiography, echocardiography and ultrasound.Ischemic cardiovascular disease and hypothyroidism were identified. However, the increase in creatine phosphokinase levels was not associated with statin use, since they were discontinued during observation, and the enzyme level increased over time. Other causes of increased creatine phosphokinase were also excluded, and the results indicate that the increase in the level of this enzyme is likely caused by a previous coronavirus infection with concomitant diseases.Conclusion. The present study highlights the importance of a comprehensive approach to the differential diagnosis and treatment of elevated creatine phosphokinase levels in patients with comorbid pathology, as this can be a consequence of various factors, including infections, concomitant diseases and pharmacological influences.

Keywords

• multinodular goiter
• retrosternal goiter
• thyrotoxicosis
• thyroidectomy
• cervicotomy
• supraventricular tachycardia